PassOver the Easter Lily and Spare Your Cat

The Easter lily

It was another typical crazy busy Monday. The phone wouldn't stop ringing and we were yet again paying the price of having the audacity of closing for a holiday the day before. Our appointments were booked, people were walking in with sick pets and we were all trying to catch up on each others holiday. 

After a day of juggling needs of all sizes and shapes I arrived home and melted on the couch. Within a few minutes I received a text from one of my groomers. She had been given an Easter Lily from a dear client and had happily brought it home. Within a few minutes of arriving in her home her cat was investigating the lily the best way they know how, nibbling on it. 

She quickly went online to investigate and then alerted me.

Here's what I told her;

Easter Lily's are a very common plant given as gifts for the Passover and Easter holiday. Unfortunately they are very, very toxic to cats.

They can cause some gi upset in dogs, but for cats even a few leaves can cause severe damage to the kidneys. Ingestion of any part of the lily is toxic. Even consuming less than one leaf can be fatal.

Within 2 hours a cat that eats a piece of the lily will usually show some or all of the following clinical signs: vomiting, lethargy, depression, and anorexia (not eating). By twelve hours the vomiting usually ceases but the lethargy and depression worsen. The blood work will also start to change at about 12 hours post ingestion. The values that we are concerned about all pertain to the kidneys. The blood urea nitrogen, creatinine, potassium, and phosphorus. These values can rise from between 12-72 hours post exposure.

For cats that we believe have recently ingested a piece of lily we induce vomiting. Vomiting in cats is a tricky predicament. The common agents that we use for dogs, hydrogen peroxide, don't work well (or at all) in cats and can be dangerous. Many practitioners use xylazine in the muscle to cause vomiting. I read one experts opinion of inducing vomiting in cats that I thought was put very well. They describe "inducing vomiting in cats is like trying to herd them, there are several things to try, but none work very well." (Tina Wismer DVM, DAVBT, DABT). These include, hydrogen peroxide, xylazine, and apomorphine. Hydrogen peroxide can cause severe gastric hemorrhage (bleeding in the stomach). After inducing vomiting we then give activated charcoal (to bind any remaining lily left in the stomach), a cathartic agent, and start i.v. fluids for about 48 hours, or until the blood levels are back to within normal range.

The treatment for cats that have ingested any pieces of a lily the recommended treatment plan is fluid diuresis via iv fluids for 48 hours. If the renal values are normal (we get a baseline at arrival) then we wean the cat off of the fluids over the next 12-24 hours. Fluid diuresis is much like people getting dialysis. We can protect the kidneys by diluting out the toxin so that less of it can damage the kidneys.

After all of this scary information the best advice is to keep the lily's out of the house and far away from cats.

The best advice that I can give you is to be proactive. If you think your cat ate even a little bit get immediate emergency care.

With love from Loon. The quiet, not-so-curious cat.

Happy Spring!, from my back yard to you.

This write up came from a Pawbly question. To discover more about Pawbly, and read other questions and responses please go to http://www.pawbly.com/

What Possesses Them To Eat....?

I am definitely guilty of having favorites. I cannot help it. I am too attached to my job and even more so (like by a degree of a hundred) to some of my patients.

Levi is one of them, without a doubt.

When he has a problem his parents can call me about it. It doesn’t matter what it it or at what time it happens. I am one phone call away, and I worry for him as much as they do.

Today, (of course it was an already too busy Monday), the clinic phone rang. It was Levi’s mom to say that he had just eaten almost 200 gauze squares. I didn’t even wait to pick up the phone to hear the explanation I just told the receptionist to tell them to come in right away.

Hasn’t everyone heard about the human patients who complain of chronic stomach pains months to years after they have had abdominal surgery? And after months to years of complaining of nondescript ghost abdominal pains find out that someone left a gauze square behind in their belly which is not adhered into a big ball of intestinal mess that has to be surgically dissected out?

As I waited for Levi to arrive I thought to myself how impossible it would probably be for close to 200 gauze squares to make it through the g.i. tract without clumping up together and plugging up his entire internal plumbing system. He had to come in right now and I had to hope that he would vomit them all up.

Levi, bouncing, dancing, wagging, happy 80 pounds of joy, arrived a few minutes later. His mom was drug behind him obviously worried about him and fittingly-so pondering what would possess him to eat a whole package of gauze. As soon as she saw me she said, “his dad left a little while ago. I knew when he saw his suitcase and pillow depart the front door with his dad that Levi would be upset. I was only out of the room for a moment and in that time he had wedged himself between the couch and the love seat and the gauze package was gone. I had just gotten a whole sleeve of gauze and tape from my doctor because my toe is infected. I had just gotten the tape out of his mouth and then the gauze disappeared. I am pretty sure that my other dog didn’t get any.”

All I could do was laugh. And thank the heaven above that Levi found these wonderful people who love him unconditionally no matter how much trouble he gets himself into.

As  Levi’s mom sat in the reception area I gave him a quick exam. As I did she told the person sitting next to her the whole sad tale again. All she could do was cover her mouth and laugh.

“Are you going to take an x-ray to see how many are in there?” she asked me.

“We always do a post-op count to make sure that we haven’t left any in a patient at my hospital.”

I could tell by her demeanor and her question that she was a nurse.

“No,” I replied, “it was gauze for her foot and they don’t put the radiopaque marker on bandaging material, just OR gauze.”

“Oh, yeah,” she replied.

“Well are you going to take him to endoscopy for removal?”

“Umm, well, this is veterinary medicine, and endoscopy requires anesthesia, and expensive endoscopy equipment, so no, we aren’t. Levi’s gauze is coming out the way it went in. the old-fashioned, cheap method of vomiting.”

I asked Levi’s mom if she could stay with us for a while while we tried to get Levi to puke up the goods. She said yes, so off we went to the treatment/surgery area.

In the treatment area I went over the plan with the staff. After each recount of Levi’s story there was laughter. 200 gauze pads, is tragic, and laughable. That’s our life in the clinic, usually a bit of both tragedy and comedy. If you can’t laugh about it you will burn out. So laugh, its good medicine.

We lined the floor with puppy pads, and started to deliver the first 60 ml dose of hydrogen peroxide.

Within ten minutes we had a pile of white gauze.

The techs counted out 86 on the first vomit pile.

Ten minutes later he got 92 more mls of peroxide, and within 10 minutes had another pile of gauze.

“Oh, Levi, buddy I empathize,” as another pile of gauze was delivered to the puppy pad on the floor, “I’ve been there.”

“Me, too,” his mom said, “food poisoning,” she added.

“Tequila,” I replied.

The third and final hydrogen peroxide dose produced only 16 gauze in a foamy pile of fluid, (the sure sign that the stomach is empty and the gauze was all out of his belly.

I reminded his mom to not let him eat for at least 3 hours, and sent her on her way with a fresh supply of veterinary gauze and tape. (Had I had any gauze with radiopaque markers I would have sent them.)

I don’t think I will ever understand the reasoning for eating gauze, but Levi is has been known to eat socks, and his parents are masters at Levi-proofing their home.

I’ll call and check on him tomorrow. I am sure they will call if they need me tonight. Some dogs sure don’t make it easy. But as Levi’s mom put it, “I know he’s bad, but he’s a really cute bad. And we love him.”

Levi left with an empty stomach and a long sad face. I think he will forgive us, and I hope I see his happy bouncy face again soon,,,just for a “hello” of course.